Method and system for swallow control resulting in improved posture and strength

ABSTRACT

A method and system for training a patient to improve swallowing, for retraining jaw muscles and for holding or keeping the jaw in a correct bite position. All of this in-turn causing an improvement in posture and increase strength. The system includes a combination of exercise and oral apparatus pieces or mouth-guards to retrain and balance the facial muscles and to develop a correct swallow. The mouth-guards of the present invention can improve biomechanical imbalance, posture and in turn athletic performance. A particular embodiment of an oral apparatus of the present invention includes top and bottom troughs for receiving top and bottom teeth into the apparatus. The troughs can be adapted to hold the upper canine teeth lower than the central and lateral incisor teeth and hold the upper teeth outside the lower teeth from the incisors to the molars. The apparatus can be pre-fabricated or custom made for a particular patient. Using heat moldable thermoplastics, some embodiments of the device can be formed in the patient&#39;s mouth after heating in hot water.

This is a continuation-in-part of application Ser. No. 11/699,694 filedJan. 30, 2007. Application Ser. No. 11/699,694 is hereby incorporated byreference.

BACKGROUND

1. Field of the Invention

The present invention relates generally to the field of relatingswallowing to posture and more particularly to a method and system forswallow control that results in an improved posture, improved upper andlower jaw position, increased strength and widening of the upper jaw'sbones and teeth.

2. Description of the Prior Art

It is known in the art that posture is affected by breathing, visualcontrol and body mobility. It is less known that posture is alsoaffected by swallowing. A poor relationship between the lower jawposition and the upper jaw can lead to a biomechanical imbalancedposture. The upper and lower jaw affects throat volume, the swallow andin turn the posture and strength; this in turn can affect athleticperformance.

It is also known in the art to use various mechanical appliances in themouth to change the relationship of the jaws, straighten teeth andstrengthen muscles. U.S. Pat. No. 3,478,429 teaches an orthodontictooth-positioner and retaining device for example. It is also known touse mechanical appliances in the mouth to provide protection in contactsports. U.S. Pat. No. 2,966,908 teaches such a mouth protector. Anotherexample is taught in U.S. Pat. Nos. 2,678,043 and 3,124,129. U.S. Pat.Nos. 2,678,043, 2,966,908, 3,478,429 and 3,124,129 are herebyincorporated by reference.

There are several deformities of the jaw that are due to imbalancedfacial muscles. For example, a retrude jaw or deep bite as well as agummy smile where the upper jaw is tipped down and more forward than thelower jaw are both caused by muscle imbalance.

The prior art generally does not teach a combination of mouth orswallowing exercise and an appliance or group of appliances to improveboth the shape of the mouth and the posture. What is badly needed is amethod that teaches various exercises coupled with appliances to improveupper and lower jaw positioning, size and shape, strength and to improveposture. It would also be advantageous to have an appliance that couldbe used to continue the treatment or exercise by wearing it at nightwhile a patient sleeps.

Most available mouth-guards do not take into account that the lower jawposition will affect posture and athletic performance. It would beadvantageous to have a mouth guard using a special approach to set thelower jaw at the swallow bite such that the body does not need tocompensate for the jaw during swallowing. A mouth guard that sets thejaw at the ideal position for swallowing would improve the biomechanicalbalanced, posture and in turn improve athletic performance.

SUMMARY OF THE INVENTION

The present invention relates to a method and system for training apatient to improve swallowing, for retraining jaw muscles and forholding or keeping the jaw in a correct bite position. All of thisin-turn causing an improvement in posture. The system includes acombination of exercise and oral apparatus pieces and/or mouth-guards toretrain and balance the facial muscles and to develop a correct swallow.The mouth-guards of the present invention can improve biomechanicalimbalance, posture and in turn athletic performance.

A particular embodiment of an oral apparatus of the present inventionincludes top and bottom troughs for receiving top and bottom teeth intothe apparatus. The troughs can be adapted to hold the upper canine teethlower than the central and lateral incisor teeth and hold the upperteeth outside the lower teeth from the incisors to the molars. Theapparatus can be pre-fabricated or custom made for a particular patient.Using heat moldable thermoplastics, some embodiments of the device canbe formed in the patient's mouth after heating in hot water.

DESCRIPTION OF THE FIGURES

Attention is directed to the following figures that better illustratesome of the concepts of the present invention.

FIGS. 1A-1G show a prefabricated full-mouth appliance used to aid in ajaw muscle exercise.

FIGS. 2A-2D show more views of the embodiment of FIG. 1.

FIGS. 3A-3D show a lower or upper mouth-guard appliance.

FIGS. 4A-4B show the lower jaw mouth-guard in a person's mouth and fromthe rear.

FIGS. 5A-5C show a night-guard appliance for use while a patient sleeps.

FIGS. 6A-6G show a full mouth mouth-guard appliance.

Several drawings and illustrations have been presented to better aid inthe general understanding of the invention. The scope of the presentinvention is not limited to what is shown in the figures.

DESCRIPTION OF THE INVENTION

The present invention relates to a method and system for training apatient to improve swallow, for retraining jaw muscles and for holdingor keeping the jaw in a correct bite position. All of this in-turncauses an improvement in posture which is improved because, with properswallow, the throat volume is increased and the oral facial muscles aremore balanced.

When a human swallows, the tongue performs a peristaltic motion pushingfood rearwards and finally down into esophagus and the stomach. The oralcavity behind the teeth is mostly occupied by the tongue. The tongue hasthe ability to rise up and down and create a wave that propels foodbackward. The swallowing process starts when a food is loaded onto thetongue. The posterior oral cavity is closed at this point at theglossopalatal gate by the rear of the tongue. The front of the tongueraises up and the back lowers causing glossopalatal gate to open, thenasal aperture to close and the larynx to elevate. The food is propelledinto the pharyngeal cavity and cleared with an anterior and posteriormovement of the tongue. The soft palate and the posterior pharynx apposethe tongue as the food enters the pharynx. The laryngeal aperture closes(protecting the lungs) as the epiglottis is pushed downward, and theupper esophageal sphincter opens allowing the food to pass into theesophagus. As the food clears the pharynx and passes down through theesophagus, the epiglottis re-opens the laryngeal aperture, and thetongue returns to its original shape opening the nasal cavity. The foodpasses on down through the esophagus to the stomach (through a secondsphincter).

A particular swallowing exercise taught by the present invention is tohave a patient cause a point about ¼-½ inch behind the tip of the tongueto touch the flex point of the palate on the roof of the mouth (the areawhere the palate starts to curve down to the incisal) with the mouthclosed. The patient presses the tongue against the roof of the mouthfrom the ¼-½ inch point to a rear point so that about ⅓ of the tongue ispressed against the roof of the mouth. The patent now swallows withoutreleasing the tongue. The rest of the tongue moves up, back, and thendown to bring the food into the pharynx. After finishing the swallow,the patient continues to keep the ⅓ of the tongue touching the palate.This exercise causes throat volume to increase by proper placing of themandible and maxillary relative to the head. This, in turn, causes theposture and strength to improve.

The exercise just described can be used in combination with one or moremouth guard appliances to correct retrude bite and other bites that arecaused by improper muscle balance, or to simply improve posture. Variousdeformities of the face and jaw are due to a deviated swallow and muscleimbalance. The upper jaw can become displaced (narrow and down from thepremolar-molar area, with the anterior area being pushed forward andsometimes tipped downward). This is a movement of the bones, and teeth.It is really a muscle problem that can be treated with an appliance andthe swallowing exercise described. Using an appliance, the patient bitesthe anterior teeth together voluntarily in a slot provided in theappliance and moves the jaw if necessary. If the patient performs thisbite exercise for a minimum of about an hour or more a day, considerableimprovement can be realized.

Turning to FIGS. 1A-1G and 2A-2D, a pre-fabricated appliance is shown.This can be pre-made with silicon or other similar materials and have apre-made upper and lower trough that will cause the teeth to move intothose positions, tip the upper jaw up and back, widen the upper jaw,retrain the jaw muscles, and reset the lower jaw to a new position. FIG.1A shows the top and bottom jaw view of the device, while FIG. 1B is across section taken at the front of the mouth. The teeth shown areincisors 1, canine 2, pre-molars 3, and molars 4. The device 5 fitsaround the teeth and has an outer lip 25. The device is shaped to fittop and bottom with a special trough 6 (12 in FIG. 1B) located toreceive the top and bottom teeth. The trough can run around from left toright around the front of the mouth. The trough normally starts at theupper right 3rd molar, then around the center of the mouth 7 and back tothe upper left 3rd molar.

On the bottom, the trough runs from the lower right 3rd molar to thelower right 3rd molar. A tongue positioner 11 of around 20 mm can beplaced at the center of the device, and can generally slant up around 5degrees. The indentations 12, 6 can be sized to match the upper andlower teeth. Particularly in FIG. 1B, incisors 13 can be seen fittinginto a section 12 of the device. The outermost separation of the troughfrom front 9 to back 10 on top is preferred to be around 7 mm. On bottomfrom front 8 to back 26 is preferred to be around 5 mm. An optional slot27 can be provided for a 1.5 mm or similar hard wire. By biting theanterior teeth (which are the central lower incisor to the central upperincisor) to a predetermined separation, the appliance can guide theteeth and move the lower jaw to the preset trough. The upper canine willbe lower by around ½ mm from the central and lateral incisors. Thepremolar to molar also pushed up. The lower canine has room to moveabove the central and lateral incisors by around ½ mm, and the premolarand molar have room to erupt higher. The upper teeth will be outside thelower teeth from the incisor to the molar with more offset on the molar.The appliance shown in FIG. 1 can be made from silicone or other similarmaterial. Since this appliance is prefabricated, there can be cuttingand sizing if required. FIG. 1C shows an embodiment of the appliance ina perspective view from the front, while FIG. 1D shows the appliancefrom the side. The tongue positioner 11 can slant upward from around 2.5to around 5 degrees.

FIG. 1E shows a section of the device. FIGS. 1F and 1G show Mand. andMax. views of the device. The bite 29 receives the molars and the front28, which has a trough or slot width of around 1 mm thick with a widthand thickness of around 2-3 mm between the upper and lower centralincisor, receives the incisors. FIG. 2A shows a facial view (lookingfrom the front) of the upper part, while FIG. 2B shows palatal view(looking from the palate or rear). FIG. 2C shows a facial view of thelower part, while FIG. 2D shows a lingual view (looking from the tongueor rear). Each part has slightly different dimensions. The dimensionsfrom notch to notch for the different parts are around 29 mm for theupper facial 30, about 22 mm for the upper palatal 31, about 25 mm forthe lower facial 32 and about 21 for the lower lingual 33. The rearthicknesses are around 1-2 mm for the upper piece 34, 35 and around 1-2mm for the lower pieces 36, 37. The total span (circumference) of theupper piece is around 80 mm, while the total span for the lower piece isaround 73 mm. These distances are determined by taking the width of eachtooth into account. The bite plane of the device is around 2-3 mm thickto receive the incisor then tapers down to around 1 mm at the end of3^(rd) molar. The Max. buccal flange height is around 12 mm at thecentral incisor (1^(st) notch) then tapers down to around 10 mm at the2^(nd) notch and then tapers down to around 1 mm at the end of 3^(rd)molar. The Max. palatal flange is around 10 mm at the 1^(st) notch thentapers down to around 8 mm at the 2nd notch, and tapers down to around 1mm at the end. The Mand. buccal flange height is around 10 mm at the1^(st) notch, then tapers down to around 8 mm at the 2^(nd) notch, andtapers down to around 1 mm at the end. The lingual flange's height isaround 10 mm at the 1^(st) notch, then tapers down to around 8 mm at the2^(nd) notch, and tapers down to around 1 mm at the end The parts shouldbe symmetric left to right, both top and bottom.

This appliance aligns the upper and lower jaw to an offset position withthe lower jaw being exercised to bite forward and up for a deep and/orretrude lower jaw. The slant of the bite plane pushes the upperposterior bones and teeth upward leaving room for the lower teeth tomove up when the patient moves the jaw so the front teeth bite together.By stretching the muscles and setting the jaw with the swallow bite, thepatient can correct a deep or retrude bite (since it is muscles thatcause these abnormal bites). A primary concept of the present inventionis that it is possible to exercise facial muscles using the techniquesand appliances herein described and illustrated. This can be donevoluntarily during the day and maintained during the night using acombination of the swallowing technique taught along with one or more ofthe appliances. It should be noted that the appliances and the preferreddimensions given are for adults; however, it is possible to use thepresent invention with children as well. The swallowing technique is thesame, but normally the appliances are made smaller to fit children'smouths. The appliances can also be made larger for a larger person.

As previously stated, the appliance of FIG. 1 can be preformed with atrough from the right 3rd molars to the left 3rd molars top and bottom.By biting the anterior teeth together, the appliance will guide theteeth (lower central incisor to upper central incisor) to the presettrough position. This causes the anterior bones to be pushed up andback. The upper canines will be around ½ mm lower than the central andlateral incisors. The premolars to molars' bones area will also bepushed up and out. The lower canine will have room to move above thecentral and lateral incisor by ½ mm, and the premolar to molar will haveroom to come up higher. The upper teeth will be outside the lower teethfrom incisor to molar with more offset on the molar.

Another type of appliance is a mouth-guard used in various athleticactivities such as football and wrestling. This type of appliance can bedesigned to set the lower jaw and swallow bite with or without athleticgear. The apparatus can be a type of mandibular orthopeadic repositionappliance (MORA) and can thus be part of an orthodontics treatment. Theappliance, combined with orthodontics can permanently set the jaw to theswallow bite position described.

The pre-made hot water moldable mouth guard appliances of the presentinvention have a general outline as follows: the troughs are around 4 mmat the incisal and around 12 mm at the end of 3^(rd) molar, There isgenerally no offset on upper and lower bite plane (No offset on bothupper buccal flange to lower buccal flange, and the same with thelingual flange).

The preferred method is to make mouth-guard appliances of the presentinvention from using pre-made, hot water thermoplastic molding or custommade. When a stock device is placed into hot water, it becomes softerand can be molded for a particular patient. This can be done directly inthe mouth. The process is to have the patient perform the swallowingexercise while the practitioner adjusts the jaw opening from duringsteps 2-5 of the process to be described as they are repeated untilthere is no head or neck movement when the patient swallows. At thistime, the doctor will mark two positions, the first from the nose andthe second from the chin and measure the opening. Then the doctor placesthe mouth guard in hot water and goes through steps 2-5 with thepredetermined measurement of the lower jaw position set.

The process for creating and sizing the mouth-guard appliances of FIGS.3-6 is generally as follows:

-   -   1. The patient stands straight.    -   2. The patient opens the mouth wide, and the doctor places two        fingers against the upper right and left canine teeth and        squeezes    -   3. The doctor places two pieces of wax against the right and        left either lower or upper premolar or molar teeth, and the        doctor pushes the 2 upper central incisors or left and right        canine with the thumb or any two fingers.    -   4. The patient bites down slowly through the wax.    -   5. Within 5 mm from the upper and lower incisors meeting, the        patient performs the swallow exercise previously described. Some        people who cannot perform the swallow exercise; then they will        swallow as they normally do. There should be no head movement        (only the Adam's apple moves).    -   6. Steps 2-5 are repeated with a slight adjustment of the lower        jaw more open or more closed until there is no head or neck        movement during the exercise swallow or normal swallow.    -   7. The doctor takes a bite registration for custom made        mouth-guard or just marking at the nose and chin for pre-made        mouth-guard to set the correct position of the upper and lower        jaw.    -   8. The appliance can be fabricated from thermoplastics or other        material.

As was stated, steps 2-5 are normally repeated until there is no head orneck movement during swallowing. The apparatus gives optimum throatvolume during swallowing. Using it, the patient can not only improve theposition of the jaws, balance the facial muscles, but also improveposture and increase strength.

An alternate method to achieve the first step is to have the patientstand straight with their eyes closed. They tilt their head down, andthen think of a string that pulls the head up at the back. With breathout, they slightly tuck in their stomach, and then slowly tilt theirhead up until the patient feels that the eyes are horizontal. This isthe correct position to perform the remaining steps.

FIGS. 3-4 show a lower (or upper) jaw mouth-guard appliance, while FIGS.6A-6G show a full mouth mouth-guard. The appliance body 14 has anocclusal bite pad 15 with a sloping variable thickness of around 2 mm 18at the 3rd molar 17 to around 5 mm 19 at the intersection of the firstpremolar and the canine 16. The notches shown in FIGS. 2-3 are used asguide lines in case there is a need to cut. The notches correlate withthe 1st-2nd molars and the 2nd-3rd molars. If the device is used as alower appliance, then the body 14 has a buccal flange. There is also alingual flange. The flanges on the body 14 act like a wrap around thelower teeth and extend beyond the teeth to the gingivae on outside toprotect the teeth, gingivae and bone from impact. The inside flange canbe thinner. The preferred dimensions of the body thickness are around 2mm thick for the buccal, 2 mm thick on the occlusal and around 1 mmthick on the lingual. The appliance shown in FIGS. 2-3 can also be madeas an upper jaw guard appliance by reversing top to bottom.

FIG. 3A shows a top view of the lower or upper appliance. FIG. 3B is alaid-flat front view to show the construction of the appliance. FIG. 3Cis a perspective view, while FIG. 3D is a side view. FIG. 4A shows alower mouth guard embodiment mounted in a patient's mouth. FIG. 4B is aback view from an angle slightly below level.

It is also possible to use the concepts of the present invention todesign a night-guard appliance that is only worn by a patient in a proneposition while sleeping. This is because during sleep, a human swallowsautomatically about once per minute and under stress a person willclench and grind. FIGS. 5A-5C show an embodiment of a night-guarddevice. A bite plate 20 can be seen in FIG. 4A which is a top view. Thedevice normally extends only from canine to canine left and right;however, an alternate embodiment can extend from premolar to premolar. Abuccal flange 21 can be seen in FIG. 5B which is a facial view. Theheight at the back 23 can be around 10 mm, while the height at the front24 can be around 15 mm. FIG. 5C shows a lingual or back view. The biteplate 20 can extend back about 20 mm 22 in the front and tilts downwardat around 15-30 degrees. The bite pad part of the device extends fromcanine to canine.

FIGS. 6A-6E show a full mouth guard appliance. FIG. 6A shows asymmetrical apparatus with a buccal and lingual flange. The palatalflange 40 can be around 1-2 mm, and the facial flange 41 can be around2-3 mm. The bite block 42 can extend back around 16 mm from the facialflange, and can be around from 2 to 7 mm thick.

FIG. 6B shows an appliance from a lingual view with a bite pad of around6 mm at the central incisal that tapers to around 2 mm at the end of the3^(rd) molar. An upper and lower lingual flange 43 a and 43 b can beseen as well as an upper and lower facial flange 44 a and 44 b. Theflanges on the upper part act to wrap around the upper teeth, and extendbeyond the teeth to the gingivae on the outside to protect the upperteeth, gingivae and bone from impact. The flanges have a thickness ofaround 2-3 mm. The lower buccal flange is extended from the bite paddown on the outside to the 3^(rd) molar, and the lingual flange tobetween the 2^(nd) and 3^(rd) notch (the flange is only at the 1^(st)molar and 2^(nd) premolar). FIG. 6C is side view section showing thefront bite block extending back 16 mm, with thickness 6 mm at the bitepad and extending at canine to canine. The facial flanges 44 a and 44 band the lingual flanges 43 a and 43 b can be clearly seen.

FIG. 6D shows appliance at the facial with the buccal flange 50 a and 50b having height around 15 mm at the 1^(st) notch (central incisor) andtapering down to around 13 mm at the 2^(nd) notch and down to around 8mm at the 3^(rd) notch and to around 1 mm at the end. The palatal flange51 has a height of around 12 mm at the 1^(st) notch which tapers toaround 10 mm at the 2^(nd) notch and then tapers down to around 4 mm atthe 3^(rd) notch and around 1 mm at the end. Since the bite block is onthe lower side (mandibular side), the buccal flange with reference tothe bite block is around 6 mm lower at the 1^(st) notch, around 4 mm atthe 2^(nd) notch and tapers down to the bite block around 0 mm at theend. The lingual flange is around 4 mm between the 2^(nd) and 3^(rd)notch.

The full mouth-guard shown in FIGS. 6F-6G can have a strap 60 connectingto the front of the mouth piece 63 that is adjustably attached to thesports headgear 64. The strap can have a slit in the middle 61, and theend can include a cross bar 62.

Several descriptions and illustrations have been presented to aid in theunderstanding of the present invention. One skilled in the art willrealize that numerous changes and variations can be made withoutdeparting from the spirit of the invention. Each of these changes andvariations is within the scope of the present invention.

1. A method for swallow control that results in increased jaw strengthcomprising: providing an oral apparatus adapted to be worn by a patientduring a swallowing exercise, the oral apparatus having both a toptrough and a bottom trough to receive said patient's teeth, the toptrough extending front-wise from an upper left third molar to an upperright third molar, the bottom trough below said upper trough extendingfrom a lower left third molar to a lower right third molar, said oralapparatus also including a tongue positioner of around 20 mm length atfront center of said apparatus slanting upward around five degrees,wherein, with said oral apparatus in place, upper canine teeth are heldlower by around ½ mm from central and lateral incisors, and lower canineteeth are held higher by around ½ mm from the central and lateralincisors; providing a swallowing exercise to said patient to bepracticed while wearing said oral apparatus, the oral apparatus havingboth a top trough and a bottom trough to receive said patient's teeth,said oral apparatus also including a tongue positioner at front centerof said apparatus slanting upward around five degrees, wherein thepatient bites the oral apparatus and practices the swallowing exercise,the swallowing exercise having the steps of: pressing a point fromaround ¼ to around ½ inch rearward of the tip of the tongue to the flexpoint of the palate; holding around ⅓ of the tongue against the roof ofthe mouth; swallowing without releasing the tongue from the roof of themouth; holding the tongue against the roof of the mouth after saidswallowing.